Branching Ratios for YAlG :Nd^3+

PURPOSE: Lateral incisional hernias remain technically challenging, and evidence supporting minimally invasive extraperitoneal reconstruction is scarce. We describe a tailored minimally invasive preperitoneal strategy avoiding posterior component separation and evaluate its early multicenter outcomes. METHODS: A retrospective multicenter cohort study included consecutive patients undergoing minimally invasive preperitoneal reconstruction for lateral incisional hernias between April 2024 and May 2026 at three specialized abdominal wall centers. Surgical access was individualized according to the condition of the linea alba and reconstructive requirements using direct Pe-TEP or Carolina's crossover. The primary outcome was technical success without posterior component separation. Secondary outcomes included perioperative variables, surgical site occurrences (SSOs), length of stay, readmissions, reoperations, chronic pain, and recurrence. RESULTS: Forty-seven patients underwent minimally invasive lateral preperitoneal reconstruction. Carolina's crossover was performed in 24 (51.1%) and direct Pe-TEP in 23 (48.9%). Concomitant midline and lateral hernias were present in 55.3%. Reconstruction was achieved in all patients without posterior component separation or open conversion. Median mesh area was 900 cm² (IQR 600-936), mean operative time 241 ± 90 minutes, and median length of stay 1 day (IQR 1-2). SSO rate was 6.4%, with no surgical site infections or procedural intervention. Median follow-up was 13.0 months (IQR 4.5-16.0). No recurrences, chronic mesh infections, chronic pain, readmissions, or reoperations occurred. CONCLUSION: A tailored minimally invasive preperitoneal strategy enables complete reconstruction of lateral incisional hernias without posterior component separation. These early multicenter outcomes support this strategy as an alternative for lateral abdominal wall reconstruction.